Tandem Versus Single Autologous Stem Cell Transplantation for High‐Risk Multiple Myeloma in the Era of Novel Agents: A Real‐World Study of China

Tandem Versus Single Autologous Stem Cell Transplantation for High‐Risk Multiple Myeloma in the Era of Novel Agents: A Real‐World Study of China

ABSTRACT Background This study compares the efficacy and safety of single autologous stem cell transplantation (ASCT) versus tandem ASCT for multiple myeloma (MM) patients in the era of novel agents. Methods A total of 112 high‐risk MM patients were included (single ASCT, (n = 57) or tandem ASCT(n =...

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Main Authors: Xuelin Dou, Juan Ren, Jiangtao Li, Xiaodan Liu, Li Bao, Yuan Chen, Peng Zhao, Yuping Zhong, Nan Peng, Lei Wen, Leqing Cao, Yang Liu, Daoxing Deng, Fengrong Wang, Liru Wang, Hui Liu, Xiaojun Huang, Xiaodong Mo, Jin Lu
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Cancer Medicine
Subjects:
autologous stem cell transplant
multiple myeloma
tandem
Online Access:https://doi.org/10.1002/cam4.70573
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Summary:ABSTRACT Background This study compares the efficacy and safety of single autologous stem cell transplantation (ASCT) versus tandem ASCT for multiple myeloma (MM) patients in the era of novel agents. Methods A total of 112 high‐risk MM patients were included (single ASCT, (n = 57) or tandem ASCT(n = 55) in this retrospective multicenter study. Responses and outcomes were evaluated. Results At 100 days after ASCT1 and ASCT2, 36 (63.2%) versus 45 (81.8%) patients achieved sCR/CR, 16 (28.1%) versus 7 (12.7%) patients achieved VGPR, and 5 (8.8%) versus 1 (1.8%) patient achieved PR, respectively, in the single and tandem ASCT cohorts. The 3‐year cumulative incidence of non‐relapse mortality and disease progression was 0% versus 7.3% (p = 0.083), and 45.8% versus 25.8% (p = 0.039), respectively, for the single and tandem ASCT cohort. The tandem ASCT cohort showed a trend of better 3‐year probability of PFS (58.1% vs. 64.7%, p = 0.064) compared with the single ASCT cohort. In multivariate analysis, ultra high‐risk and achieving<VGPR response after ASCT1 were associated with an inferior PFS. Ultra high‐risk was also associated with an inferior OS. Conclusions Tandem ASCT demonstrated improved outcomes compared to single ASCT in high‐risk MM patients receiving triplet or quadruplet induction and maintenance therapy. However, patients with ultra high‐risk cytogenetics may require innovative therapeutic approaches, as tendem ASCT does not overcome their adverse prognosis.
ISSN:2045-7634

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